Welcome!

SYMPTOMS

• Efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned

• A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealisation) to extreme dislike or anger (devaluation)

• Distorted and unstable self-image or sense of self

• Impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.

• Self-harming behaviour, such as cutting

• Recurring thoughts of suicidal behaviours or threats

• Intense and highly changeable moods, with each episode lasting from a few hours to a few days

• Chronic feelings of emptiness

• Inappropriate, intense anger or problems controlling anger

• Difficulty trusting, which is sometimes accompanied by irrational fear of other people’s intentions

• Feelings of dissociation, such as feeling cut off from oneself, seeing oneself from outside one’s body, or feelings of unreality. Not everyone with borderline personality disorder experiences every symptom. Some individuals experience only a few symptoms, while others have many.
  
  

CAUSES

• Genetics - It has been put forward that if mental illness is within your family you are more predisposed to developing a mental illness too. This doesn't mean it has to be BPD specifically but any variety of mental illnesses like depression, bipolar etc. However it's not an absolute either way.

• Brain Chemicals - It's thought that many people with BPD have something wrong with the neurotransmitters in their brain, particularly serotonin. Neurotransmitters are "messenger chemicals" used by your brain to transmit signals between brain cells. Altered levels of serotonin have been linked to depression, aggression and difficulty controlling destructive urges.

• Brain Development - Researchers have used magnetic resonance imaging (MRI) scans to study the brains of people with BPD. MRI scans use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed that in many people with BPD, three parts of the brain were either smaller than expected or had unusual levels of activity. These parts were:

  • the amygdala - which plays an important role in regulating emotions, especially the more "negative" emotions, such as fear, aggression and anxiety

  • the hippocampus - which helps regulate behaviour and self-control

  • the orbitofrontal cortex - which is involved in planning and decision making

• Environmental Factors - A number of environmental factors seem to be common and widespread among people with BPD. These include:

  • being a victim of emotional, physical or sexual abuse

  • being exposed to chronic fear or distress as a child

  • being neglected by one or both parents.

COMORBIDITIES
The term “comorbidity” describes two or more disorders or illnesses occurring in the same person. They can occur at the same time or one after the other. Comorbidity also implies interactions between the illnesses that can worsen the course of both. Eight common comorbidities associated with BPD

• Anxiety disorder: 35%

• Depression: 32%

• Dysthymia: 10%

• Substance abuse: 72%

• PTSD: 40%

• Panic disorder: 20%

• Eating disorders: 25%

• Bipolar: 20%

COMMON TERMS

• Depersonalisation - Depersonalisation is a type of dissociation; it is the detachment from the self. It is an alteration to one’s experience or perception so that it feels as if one is not real. This includes internal (mind) as well as external experiences of the self (body). Depersonalisation can be the experience that one does not have any thoughts or feelings, or the experience that one is an observer to one’s own body.

• Derealisation - Derealisation is a type of dissociation; it is the detachment from your surroundings. It is an alteration to one’s experience or perception so that it feels as if the external world is not real. Whereas depersonalisation is the feeling of unreality of the sense of self, derealisation is the feeling of unreality of the external world.

• Devaluation - Devaluation is a form of black-and-white thinking in which the subject believes that a person is bad. It is accompanied by feelings of great anger and dislike. Although it can happen because of many reasons, devaluation is often triggered when someone does not meet idealised expectations. Devaluation is the opposite of idealisation. When someone goes from idealising a person to devaluing them (or vice versa), they are splitting.

• Dissociation - Simply put, dissociation is a detachment from your surroundings (derealisation), yourself (depersonalisation), your memories (amnesia), or your identity (identity confusion), or a shift in identity (identity alteration). Dissociative symptoms include the feeling that you are in a film, the detachment from your feelings or thoughts, the feeling that you experience the world through a fog, and the inability to recognise your reflection. People with BPD often experience dissociation in stressful situations.

• Favourite Person (FP) - A favourite person is someone a person with BPD has imprinted on - someone they idealise, someone they depend on and whose attention they crave a lot. In many cases this is a significant other, but not everyone has a significant other and for some people it may be someone else entirely. Not everyone with bpd imprints on people, and not everyone who imprints on people has a favourite person. It is possible to have more than one favourite person.

• Idealisation - Idealisation is a form of black-and-white thinking in which the subject believes that a person is ideal. It is accompanied by feelings of admiration and love. When someone idealises someone, they put them on a pedestal: everything the person does is good and all bad behaviour is either ignored or explained as good. Someone who is heavily idealised is often referred to as a favourite person. Idealisation is the opposite of devaluation. When someone goes from idealising a person to devaluing them (or vice versa), they are splitting.

• Impulsivity - When someone acts on impulse, they act without forethought. This means that one acts without thinking their actions through or considering the possible consequences. This can include a sudden change of appearance (such as: a haircut, a tattoo, a piercing), the use of a substance, or a purchase.

• Splitting - Splitting, also known as black-and-white or all-or-nothing thinking, is a self-defence mechanism that makes one think someone or something is either extremely positive (idealisation) or extremely negative (devaluation) — i.e. fantastic or terrible, interesting or dull, nice or mean. There are, so to speak, no grey areas; people who split cannot grasp that something can be, for example, interesting overall but dull at some points. The phenomenon is based on the difficulty of integrating both negative and positive qualities in one whole. Instead of thinking of something as having a few positive qualities and a few negative ones, one ignores all good ones in favour of all bad ones, or vice versa.

• Self Harm - Self harm or self injury, is defined as the intentional, direct injuring of one's self, done without suicidal intentions. Other terms such as cutting and self mutilation have been used for any self harming behaviour regardless of suicidal intent. The most common form of self harm is using a sharp object to cut one's skin. Other forms include behaviour such as burning, scratching, or hitting body parts. Although suicide is not the intention of self harm, the relationship between self-harm and suicide is complex, as self harming behaviour may be potentially life-threatening. There is also an increased risk of suicide in individuals who self harm and self harm is found in 40–60% of suicides. However, generalising individuals who self-harm to be suicidal is, in the majority of cases, inaccurate.

• Suicidal Ideation - Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting thoughts, to extensive thoughts, to detailed planning, and incomplete attempts, which may be deliberately constructed to not complete or to be discovered, or may be fully intended to result in death, but the individual survives. Suicidal ideation is generally associated with depression and other mood disorders; however, it seems to have associations with many other mental disorders, life events, and family events, all of which may increase the risk of suicidal ideation. For example, many individuals with borderline personality disorder exhibit recurrent suicidal behaviour and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts. Currently, there are a number of treatment options for those experiencing suicidal ideation. 1 in 10 are successful in a suicide attempt.
  

TREATMENTS

• Psychotherapy - Therapies such as dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT) and psychodynamic psychotherapy—is the first line of choice for BPD. Learning ways to cope with emotional dysregulation in a therapeutic setting is often the key to long-term improvement for those experiencing BPD. There are many options and different things will work for different people.

• Medications - Medication may be instrumental to a treatment plan, but there is no one medication specifically made to treat the core symptoms of BPD. Rather, several medications can be used off-label to treat various symptoms. For example, mood stabilisers and antidepressants help with mood swings and dysphoria. And for some, low-dose antipsychotic medication may help control symptoms such as disorganised thinking.

THINGS TO DO

• Speak to a medical professional, preferably a psychiatrist as they are trained in mental illness. GP’s generally have minimal background in mental illness. Also try to get into intensive therapy such as DBT and see a psychologist either through DBT or privately.

• Research and read up on BPD and comorbidities (eg: depression, anxiety) to gain an understanding on what causes BPD, common behaviours, symptoms and treatments.

• Be non-judgemental of others and yourself. Your emotions are valid, they come from a very real place, so don’t be hard on yourself. Others may not understand or know how to react so don’t judge them harshly either.

• Keep a mood diary – a great way to keep track of emotions. Ideas/samples below in resources.

• Plan ahead – make a crisis plan for times when things escalate, especially into dangerous behaviour as self harm or suicide attempts. See what the include in a crisis plan below, these should be made with your doctor, peer support works or family/friends.

• Learn/identify your triggers, Being aware of where/what’s cause a reaction is half the battle, write them down and discuss with your supports.

• Join some support groups either in real life or online, they can offer insight and a feeling of comradery.

• Take care of yourself, try self care and self soothing ideas to look after both physically and emotional needs. These include simple things as showering to eat healthy meals. The simplest things seem to become the hardest when you’re doing it hard.